Preventive surgeries for breast, ovarian cancer to be covered by Medishield Life & Medisave: Ong Ye Kung

In Singapore, around one in 150 individuals carry a gene mutation that is associated with Hereditary Breast and Ovarian Cancer (HBOC) syndrome.

This mutation significantly increases a woman's lifetime risk of developing breast and ovarian cancer — two of the deadliest cancers affecting women in Singapore.

To improve prevention and early intervention, the government will introduce two new measures this year.

First, the government will offer subsidised genetic testing to individuals at risk for HBOC.

Second, selected preventive surgeries — including mastectomies — will be covered by Medishield Life and Medisave.

Early intervention

The new measures were announced by Health Minister Ong Ye Kung at the Mar. 5 Committee of Supply debate in parliament.

The subsidised genetic testing, to be introduced in December this year, will be extended to individuals with a family history of HBOC, or breast and ovarian cancer.

Over 2,000 individuals are expected to be eligible for the test annually, Ong said.

He added that the test will be "affordable". In addition to subsidies, individuals can offset the cost of the test using Medisave.

Those found to have the mutation will then be offered suitable preventive interventions.

Preventive surgeries

Apart from mammograms or oral medication, some individuals may opt for surgical interventions.

An example is actress Angelina Jolie, who in 2013 underwent a preventive double mastectomy (surgical removal of the breast).

She had tested positive for the BRCA1 gene mutation, which gave her an 87 per cent chance of developing breast cancer.

For individuals at risk of ovarian cancer, there is also the option of removing the fallopian tubes and ovaries to reduce the chances of cancer.

MediShield coverage

Currently, such preventive surgeries are not covered by MediShield Life, and as such individuals are unable to make claims under insurance.

This is for good reason, said Ong, namely to keep coverage focused and premiums affordable.

However, "with advances in medical science, the boundary between preventive and curative cure is increasingly blurred".

He pointed out that if a high-risk individual is unable to undergo a preventive mastectomy, she has a high chance of eventually needing cancer treatments, including a curative mastectomy to remove cancerous breast tissue.

As such, there is clear clinical need, a minimal risk of abuse, is suitable for risk-pooling through insurance, and does not financially burden the MediShield Life scheme.

"We will therefore extend MediShield Life and Medisave to cover preventive surgeries for HBOC later this year," Ong said, to resounding armchair-thumping.

"I think this is a meaningful policy change ahead of International Women's Day on Mar. 8."

Breast reconstruction remains a covered procedure under the national health insurance schemes.

Top image via MDDI/YouTube and Angelina Jolie Instagram.